Provider Demographics
NPI:1578019287
Name:MILES, EFIA R (LCSW)
Entity Type:Individual
Prefix:
First Name:EFIA
Middle Name:R
Last Name:MILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 GLENWOOD AVE SE STE 510-301
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1966
Mailing Address - Country:US
Mailing Address - Phone:404-514-9982
Mailing Address - Fax:404-393-3917
Practice Address - Street 1:830 GLENWOOD AVE SE STE 510-301
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-1966
Practice Address - Country:US
Practice Address - Phone:404-514-9982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0058141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical